Formulary
Lidocaine with prilocaine: Indications, Dosing, Side Effects and Interactions
Lidocaine with prilocaine clinical drug profile including indications, dosing, side effects, cautions and interactions.
MedNext Academy | 4 min read
Lidocaine with prilocaine: Indications, Dosing, Side Effects and Interactions
Lidocaine with prilocaine clinical drug profile including indications, dosing, side effects, cautions and interactions.
Indications and dose
**Anaesthesia before minor skin procedures including venepuncture**
- **Child** (To The Skin): 12-17 years Apply 1-5 hours before procedure (2-5 hours before procedures on large areas e.g. split skin grafting), a thick layer should be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca).
- **Adult** (To The Skin): Apply 1-5 hours before procedure (2-5 hours before procedures on large areas e.g. split skin grafting), a thick layer should be applied under occlusive dressing.
**Anaesthesia on genital skin before injection of local anaesthetics**
- **Adult** (To The Skin): Apply under occlusive dressing for 15 minutes (males) or 60 minutes (females) before procedure.
**Anaesthesia before surgical treatment of lesions on genital mucosa**
- **Adult** (To The Skin): Apply up to 10 g, to be applied 5-10 minutes before procedure.
**Anaesthesia before cervical curettage**
- **Adult** (To The Skin): Apply 10 g in lateral vaginal fornices for 10 minutes.
**Anaesthesia before mechanical cleansing or debridement of leg ulcer**
- **Adult** (To The Skin): Apply up to 10 g for 30-60 minutes, to be applied under occlusive dressing.
**Primary premature ejaculation**
- **Adult** (To The Skin): 3 sprays every 4 hours as required, to be applied to cover the glans penis (excess spray should be removed after 5 minutes and before intercourse); maximum 9 sprays per day.
**Anaesthesia before minor skin procedures including venepuncture for lidocaine with prilocaine**
- **Neonate** (To the skin): Apply up to 1 g for maximum 1 hour before procedure, to be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 1 dose per day.
- **Child 1-2 months** (To the skin): Apply up to 1 g for maximum 1 hour before procedure, to be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 1 dose per day.
- **Child 3-11 months** (To the skin): Apply up to 2 g for maximum 1 hour before procedure, to be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 2 doses per day.
- **Child 1-11 years** (To the skin): Apply 1-5 hours before procedure, a thick layer should be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca); maximum 2 doses per day.
- **Child 12-17 years** (To the skin): Apply 1-5 hours before procedure (2-5 hours before procedures on large areas e.g. split skin grafting), a thick layer should be applied under occlusive dressing, shorter application time of 15-30 minutes is recommended for children with atopic dermatitis (30 minutes before removal of mollusca).
**Anaesthesia on genital skin before injection of local anaesthetics for lidocaine with prilocaine**
- **Child 12-17 years** (To the skin): Apply under occlusive dressing for 15 minutes (males) or 60 minutes (females) before procedure.
**Anaesthesia before surgical treatment of lesions on genital mucosa for lidocaine with prilocaine**
- **Child 12-17 years** (To the skin): Apply up to 10 g, to be applied 5-10 minutes before procedure, maximum dose should be proportionally reduced in adolescents with body-weight less than 20 kg.
**Anaesthesia before cervical curettage for lidocaine with prilocaine**
- **Child 12-17 years** (To the skin): Apply 10 g in lateral vaginal fornices for 10 minutes.
Cautions
For Fortacin Acquired methaemoglobinaemia; anaemia; congenital methaemoglobinaemia
Contraindications
For lidocaine with prilocaine Use in child less than 37 weeks corrected gestational age
Side effects
For lidocaine with prilocaine Common or very common Sexual dysfunction (in adults) Uncommon Fever (in adults); headache (in adults); penis disorder (in adults) Rare or very rare Methaemoglobinaemia; skin reactions Side-effects, further information When applied to the glans penis, side-effects for sexual partners should be considered. Side-effects reported in female partners include vaginal candidiasis and dysuria.
Pregnancy
For Fortacin Manufacturer advises preferably avoid unless an effective male barrier contraceptive is used-limited information available.
Hepatic impairment
For Fortacin Manufacturer advises caution in severe impairment (no information available).
Medicinal forms
Cream,Solution
Clinical governance
**Author:** MedNext Clinical Team. **Clinical reviewer:** Dr Shameer Deen, MBBS, MS, MRCS. **Sources:** BNF, Indian Pharmacopoeia, CIMS India. **Correction:** Report errors at support@mednext.academy.
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